ABSTRACT
On a variety of occasions and in a variety of ways those who use maternity care services have made organized efforts to change the way care at birth is given. How have these consumer actions affected maternity care policies? We use case studies from three countries-Canada, Britain, and the United States-to explore the strategies and outcomes of consumer efforts to reshape maternity care. These three countries represent a continuum in the politics of maternity care. In Canada and the United States, the maternity care division of labor is characterized by medical dominance; midwives play a minimal, supportive role (Bourgeault & Fynes 1997). Britain, on the other hand, has a long tradition of independent midwifery practice, although maternity care policies created after World War II have favored physicians and hospital birth.
